How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $457.09 Median $2,290.87 Typical High $4,365.16 | Facility | None | $457.09 | $2,290.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $457.09 | Professional | None | $398.11 | $398.11 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,737.80 | Facility | None | $676.08 | $1,071.52 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,348.96 | Professional | None | $776.25 | $1,047.13 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $758.58 Typical High $1,202.26 | Facility | None | $549.54 | $758.58 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,047.13 Typical High $3,388.44 | Professional | None | $478.63 | $1,047.13 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,023.29 | $1,047.13 | $1,047.13 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,995.26 | Facility | None | $645.65 | $1,071.52 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Sanford Health Plan Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $891.25 | Professional | None | $446.68 | $645.65 | $891.25 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $426.58 Median $870.96 Typical High $1,258.93 | Professional | None | $426.58 | $870.96 | $1,258.93 |
Wellmark Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,096.48 | Professional | None | $954.99 | $1,096.48 | $1,096.48 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | 52 · Reduced service | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $316.23 |
Where South Dakota sits
The same service costs 6.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Dakota· 5th of 51
$1,023
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.